With only three official cases, Africa’s low coronavirus rate puzzles health experts

Whether it is faulty detection, climatic factors or just a fluke, the remarkably low rate of coronavirus infection in African countries, with their fragile health systems, continues to surprise – and worry – the experts.

To date, only three cases of infection have been officially recorded in Africa, one in Egypt, one in Algeria and one in Nigeria, with no deaths.

This is a remarkably low number for a continent of nearly 1.3 billion inhabitants, and barely a drop in the ocean for more than 86,000 cases and nearly 3,000 deaths recorded in sixty countries across the world.

Shortly after the virus appeared, specialists warned of the risks of its spread in Africa, due to the continent’s close trade links with Beijing and the fragility of its medical services.

“Our greatest concern remains the potential for the spread of Covid-19 in countries with weaker health systems,” said Tedros Adhanom Ghebreyesus, head of the World Health Organization, to the ministers of health of the world. African Union meeting in Addis Ababa, the Ethiopian capital, in February. 22.

In a study published in The Lancet medical journal on African countries’ preparedness and vulnerability to the import of Covid-19, an international team of scientists has identified Algeria, Egypt and South Africa as most likely to import new cases of coronavirus into Africa, although they also have the best prepared health systems in the world. continent and be the least vulnerable.

‘Nobody knows’

As to why the epidemic is not more widespread on the continent, “nobody knows,” said Professor Thumbi Ndung’u, of the African Institute for Health Research in Durban, South Africa. “Maybe there just aren’t a lot of trips between Africa and China.”

But Ethiopian Airlines, the largest African airline, has never suspended flights to China since the start of the epidemic, and China Southern resumed flights to Kenya on Wednesday. And, of course, people with coronaviruses could enter the country from any of the other 60 countries with known cases.

Favorable climatic factors were also mentioned as a possibility.

“Perhaps the virus is not spreading in the African ecosystem, we don’t know,” said Professor Yazdan Yazdanpanah, head of the infectious diseases department at Bichat hospital in Paris.

This hypothesis was rejected by Professor Rodney Adam, who heads the infection control working group at Aga Khan University Hospital in Nairobi, Kenya. “There is no current evidence to indicate that the climate is affecting transmission,” he said. “While it is true that for certain infections, there may be genetic differences in susceptibility … there is no current evidence to this effect for Covid-19.”

Nigeria well equipped

The Lancet study revealed that Nigeria, a country at moderate risk of contamination, is also one of the best equipped on the continent to cope with such an epidemic.

But scientists did not foresee that the first case recorded in sub-Saharan Africa would be an Italian working in the country.

Just over a week ago, “our model was based on a concentrated epidemic in China, but since then the situation has completely changed and the virus can now come from anywhere.” Mathias Altmann, an epidemiologist at the University of Bordeaux and one of the report’s co-authors, told FRANCE 24 on Friday. The short lifespan of the studies testifies to the speed of spread of the epidemic.

The Italian, who tested positive for coronavirus in Lagos, arrived from Milan on February 24 but had no symptoms when his plane landed. He was quarantined four days later at the Yaba infectious disease hospital. Several people from the company where he works have been contacted and the authorities are trying to find other people with whom he may have had contact.

Altmann, an infectious disease expert in developing countries, said that the coronavirus appeared to have entered sub-Saharan Africa through Nigeria is “actually good news” because the country seems relatively well prepared to deal with the situation.

In a continent which “has had its share of epidemics and whose countries therefore have a great knowledge of the terrain and a real competence to react to this kind of situation”, Nigeria is in a very good position to face the arrival from Covid- 19, Altmann said.

“The CDC[Center for Disease Control] responsible for the entire region of West and Central Africa is located in Abuja, the capital of Nigeria, which means that their level of organization in health matters is very high, “he added. .

The country was already renowned for “having successfully contained the Ebola epidemic fairly quickly in 2014,” said Altmann. It only took the Nigerian authorities three months to eradicate Ebola from the country. The World Health Organization and the European Center for Disease Prevention and Control at the time praised Nigeria for its responsiveness and “World class epidemiological detective work”.

But despite Nigeria’s strengths, the coronavirus pathogen poses a particular challenge because it is difficult to detect. The virus can be present in a person who presents little or no symptoms, which allows him to spread quietly in a country where, like everywhere in Africa, there is “a shortage of equipment compared to Western countries, in particular in diagnostic tools, “said Altmann. .

Neighboring countries like Chad and Niger have “less functional capacity to manage an epidemic,” said Altmann. But they also have an advantage: these are agricultural regions where people are more outside, “and viruses like this prefer enclosed spaces and are less likely to spread in rural areas,” he said. he adds.

(FRANCE 24 with AFP)